September 1, 2014

When the day finally arrives for your Social Security disability hearing, you may find that the Administrative Law Judge (ALJ) has asked one or more doctors to testify about your ability to do work-related activities. Some, but not all, Administrative Law Judges call on medical experts to testify at hearings. You may be wondering how a doctor who has never seen you before can testify about your medical conditions and how they affect your ability to work. In my experience, medical expert testimony at a disability hearing has both advantages and disadvantages. An experienced disability attorney knows how to prepare for a hearing to maximize those advantages while defending against the disadvantages. Some doctors who testify at hearings appear in person, but many testify over the phone. Social Security pays each medical expert a flat fee to review a claimant’s medical file and provide unbiased testimony at the hearing. In my experience, the Social Security Administration (SSA) has difficulty finding qualified doctors to testify; most practicing physicians have neither the time nor the financial incentive to work as a medical expert for Social Security. Most of the doctors I see at hearings are retired general practitioners. While the ALJs typically request testimony from doctors who specialize in the claimant’s impairments, it is often difficult for Social Security to find such a specialist who is available to testify. Each medical expert at your hearing is expected to have reviewed all of the medical records in your file and be prepared to present his opinions on the following issues: Your medical diagnoses Whether your impairments meet or equal the definitions set out in Social Security’s “Listing of Impairments” The physical and/or mental work-related limitations caused by your impairments The ALJ will likely ask the medical experts some additional questions, and you or your representative will have an opportunity to ask questions as well. Many judges … Continued

August 26, 2014

When I prepare my Indiana neighbors for their day in front of an Administrative Law Judge (ALJ), the majority of the conversation revolves around what type of questions the ALJ will ask them. I have represented clients in front of many different judges, and I have found that each ALJ has a unique style of asking questions – some ask a lot of questions; others prefer to have the representative take most of the client’s testimony. Therefore, I try to tailor each of my clients’ preparation to be ready for the particular judge who will be hearing the case. In spite of their differences, though, in my experience most judges cover the same general topics in their hearings. Many, but not all, judges are going to check your credibility. While objective test results can prove that you have a certain medical diagnosis, the severity of the pain or other symptoms you experience due to that diagnosis can only be explained by you. Therefore, the judge will likely ask you to explain your symptoms, rate your pain, or describe the ways your pain or other symptoms limit your ability to perform certain tasks. If a judge believes you are exaggerating or lying about these things, you may find yourself with an unfavorable outcome. I try to always tell my clients to be truthful yet realistic about what they can or cannot do. In my experience, credibility is especially important for my clients whose disabilities cannot be diagnosed with objective testing, like mental illness, fibromyalgia, or migraines. Most judges will ask you about your activities of daily living. These can include but are not limited to cleaning your home, doing dishes, laundry, yard work, bathing or showering, dressing yourself, taking care of children, shopping, using the computer, hobbies, and going out with friends and … Continued

August 21, 2014

In order to qualify for disability benefits, you must have a disability that has lasted or is expected to last at least twelve months. Although, sometimes I work with clients whose health problems lasted more than twelve months, but they have recovered and are now able to return to work. Even though they are relieved to be able to return to full-time employment, these clients want to know if they can receive disability benefits for that time period in which their conditions kept them from being able to work. In cases like these, we ask the Social Security Administration (SSA) for a “closed period of disability.” In other words, we acknowledge that the client does not presently meet Social Security’s definition of disabled, but we argue that the client did meet that definition in the past. For example, Betty had to stop working in October of 2012 after she injured her back. She spent nine months trying different types of treatments, from physical therapy to injections, but nothing helped. Finally, her doctor scheduled her for back surgery in August of 2013. It took another six months of recovery and rehabilitation, but Betty was finally able to return to work full-time in February of 2014. Assuming that Betty met Social Security’s requirements for disability from the time of her injury in October 2012 until she returned to work in February 2014, she could receive benefits for a closed period from October 2012 to February 2014. An applicant for a closed period of disability must meet two criteria: Her impairments must have prevented her from performing substantial gainful activity for at least twelve continuous months; and She must have applied for disability either before her disability ended or within fourteen months of her disability ending. Most of my cases involving closed periods of … Continued

July 24, 2014

Hepatitis C (HCV) is a medical condition in which the patient’s liver is inflamed. In some cases, HCV can lead to cirrhosis (replacement of liver tissue with scar tissue) of the liver. Hepatitis C is usually spread via organ transplants, transfusions, intravenous drug use, or poorly sterilized medical equipment. HCV was only proven to be a different condition from hepatitis A and hepatitis B in 1989. HCV only infects humans and chimpanzees. Chronic infection occurs in about 80% of HCV patients. A chronic infection is characterized by the presence of viral replication for more than six months. Most patients with chronic HCV infection exhibit few symptoms, if any, during the first few decades after their initial infection. Early symptoms may include fatigue or mild cognitive problems. After several years of an individual being infected, hepatitis C may lead to cirrhosis or liver cancer. Some other symptoms may include: Joint pain Belly pain Itchy skin Sore muscles Dark urine Jaundice Traditionally, the typical treatment for hepatitis C has been interferon injections. Unfortunately, though, these injections tend to cause flu-like side effects. New drugs are being introduced to replace interferon treatment, and if a patient’s HCV symptoms are not severe, his doctor may recommend waiting for the new drugs to be released rather than enduring interferon treatment. Patients with hepatitis C are typically advised to avoid alcohol and any type of medication or drug that is harmful to the liver. The Social Security Administration (SSA) has a listing for chronic liver disease in its Listing of Impairments at Section 5.05. Simply being diagnosed with hepatitis C is not enough on its own to meet the criteria to receive Social Security disability benefits. Your medical records must also show that you have complications such as hepatorenal or hepatopulmonary syndrome, internal bleeding, or fluid in the peritoneal or pleural cavity. Even if you do … Continued

July 10, 2014

Your social security disability claim may be denied due to alcohol or drug use. The way this information usually gets to the Social Security Administration (SSA) is through the medical records. Most doctors offices ask questions concerning drugs and alcohol when patients go in for a check up. Some hospitals will conduct drug tests while patients are in for a procedure. Below is a paraphrased version of what the SSA’s Federal Regulation 416.935 says concerning drugs and alcohol: If the SSA finds that you are disabled, they must determine if your drug or alcohol addiction is a contributing factor to your disability. This does not apply to claimants when applying because of blindness. If you stopped using drugs or alcohol, would the SSA still find you disabled? Would your current physical or mental limitations remain if you stopped using drugs or alcohol? If the SSA determines that your remaining limitations (after removing the drug or alcohol use) would not be disabling, you may not receive benefits. If the SSA determines that your remaining limitations (after removing the drug or alcohol use) are still disabling, you may be found favorable for benefits. How the SSA looks at drug and alcohol use varies from case to case. In cases where the claimant is claiming mental health issues, the SSA will look and determine, in their opinion, if the claimant stopped using drugs or alcohol, would the condition still exist? This can be a gray area with mental health cases because far too often I see drugs or alcohol become a coping mechanism for mental issues. If you have drug or alcohol issues, your case may be harder to win, but this does not mean that it is impossible. We must prove to the SSA that the drug or alcohol issues are independent … Continued

May 29, 2014

A traumatic brain injury (TBI) occurs when an external mechanical force causes damage to the brain. These injuries may occur as a result of vehicle accidents, firearms, falls, construction accidents, or sports injuries. A TBI may cause temporary or permanent impairment of brain functioning and might cause structural damage to the brain as well. Symptoms from TBIs vary depending on the severity of the injury. In moderate or severe cases, unconsciousness may occur within seconds or minutes. Milder injuries may cause symptoms including but not limited to: headaches, vomiting/nausea, dizziness, balance problems, and fatigue. Some common long term symptoms of moderate to severe TBIs may include but are not limited to: changes in appropriate social behavior; problems with sustained attention, processing speed, and executive functioning; and alexithymia. Alexithymia is a condition in which an individual has problems identifying, understanding, processing, and describing emotions. the Journal of Clinical and Experimental Neuropsychology reports that 60.9% of patients diagnosed with TBI suffer from alexithymia. The Social Security Administration (SSA) recognizes traumatic brain injuries in its Listing of Impairments at Section 11.18 – Cerebral Trauma. In evaluating whether your TBI meets a listing, though, the SSA refers to other listings that address the specific body systems affected by your injury. For example, if you suffer psychological or behavioral symptoms resulting from your TBI, you may meet Listing 12.02 – Organic Mental Disorders. If your TBI leads to seizures, you may meet listing 11.02 – Convulsive Epilepsy or 11.03 – Nonconvulsive Epilepsy. In order to meet Social Security’s definition of disability, your impairment must have lasted or be expected to last at least twelve months. TBIs can be difficult to evaluate under Social Security’s standard because their long-term prognoses can be difficult to forecast accurately. Some TBIs cause very severe symptoms at first but gradually improve, while others grow worse over time. Therefore, it is very important in your Social Security disability case … Continued

May 22, 2014

Your initial consultation with our office is free, and there are many reasons why. When you call our office to initially discuss your claim, you will probably have many questions. So will we. We will need to talk to you to get an idea of whether you qualify for one of Social Security’s disability programs. Also, during this first interaction with you we can get pertinent information that will give us a better “feel” for how we can help you. Some of the questions we will probably ask you include, but are not limited to: Are you still working? It is possible to qualify for Social Security disability benefits even if you are working, but there are limits on the number of hours you can work and the amount of monthly gross income you can earn. When is the last time you worked? What is your household income? The Social Security Administration (SSA) has two disability programs: eligibility for Social Security Disability insurance (SSDI) is based on the number of work credits you have earned in the past ten years; Supplemental Security Income (SSI) is based on your household income and financial resources. What medical conditions do you have that keep you from being able to work? These conditions can be mental, physical, or a combination of both; Social Security typically requires medical evidence showing that you have been diagnosed with these conditions and are receiving treatment for them. There are many other factors involved in a Social Security disability claim, including your age, education, and prior work experience. You may wonder why these things are important. The SSA determines your ability to work based on many things. In some cases, Social Security takes into account the fact that there are fewer job opportunities in the economy for people over the age of fifty. … Continued

May 20, 2014

The Social Security Administration (SSA) recognizes many cardiovascular impairments as disabling conditions. Many people use the term heart disease interchangeably with cardiovascular impairments. The SSA defines a cardiovascular impairment as “any disorder that affects the proper functioning of the heart or the circulatory system (that is, arteries, veins, capillaries, and the lymphatic drainage). The disorder can be congenital or acquired.” The SSA lists cardiovascular impairments under Section 4.00 in the Listing of Impairments. The Listings define certain diagnoses, clinical findings, and symptoms that the SSA considers disabling. If you can provide appropriate medical evidence showing that your impairment meets the definitions set out in the Listings, you might be found disabled without having to demonstrate how your impairment keeps you from being able to work. Below are a few cardiovascular impairments that the Social Security Administration addresses in its Listing of Impairments. Chronic Heart Failure Chronic heart failure occurs when the heart is unable to pump enough blood to meet the needs of the body. Some signs and symptoms of heat failure may include: increased rate of breathing, increased difficulty for normal breathing, pulmonary edema, cardiac asthma (wheezing), and/or apex beat or gallop rhythm. Heart failure stems from the myocardium muscle losing efficiency, which is usually caused by damage or or overloading of the muscle. The leading cause of chronic heart failure is coronary artery disease. The SSA recognizes chronic heart failure in Section 4.02 of the Listing of Impairments. To meet this listing you must be able to show certain levels of systolic or diastolic failure, severe symptoms as a result of your heart failure, or multiple episodes of acute congestive heart failure. Ischemic Heart Disease Ischemic heart disease is more commonly known as coronary artery disease. This condition happens when blockages in the arteries reduce blood flow. Ischemia is defined as “reduced blood supply.” The leading cause of ischemic heart disease … Continued

May 7, 2014

The pancreas is a large gland located behind the stomach. It is part of the endocrine and nervous systems. The pancreas produces many important hormones that circulate in the blood. It also produces digestive enzymes that help break down food. Pancreatitis occurs when the pancreas becomes inflamed. Damage to the pancreas can occur when pancreatic enzymes activate before they are secreted. There are two main types of pancreatitis: Acute pancreatitis happens over a very short period of time. This type of pancreatitis is usually caused by gallstones or heavy drinking. Symptoms may include: Fever Nausea/vomiting Upper abdominal pain/swollen or tender abdomen Increased heart rate Chronic pancreatitis usually results after a case of acute pancreatitis. Chronic pancreatitis can ultimately stem from gallstones, hereditary disorders, cystic fibrosis, certain medicine, or heavy alcohol use. Symptoms may include: Any symptoms of acute pancreatitis Weight loss Diabetes In order to be eligible for Social Security disability benefits, you must have a disability that has lasted at least twelve months, is expected to last at least twelve months, or is expected to end in death. If you have chronic pancreatitis, you may be eligible for Social Security disability benefits if you can show that your condition is disabling according to Social Security’s rules. One of the first things you must do in a Social Security disability claim is to show that you have a “medically determinable impairment.” In other words, your condition must be diagnosed using acceptable medical clinical or laboratory techniques. It is important to see a specialized physician such as a gastroenterologist or endocrinologist if you are diagnosed with pancreatitis. Not only will a specialist be most likely to accurately diagnose and treat your condition, medical records from a specialized physician are likely to be given more weight by Social Security’s disability evaluators … Continued

April 24, 2014

Diverticulitis is a fairly common digestive disease. The severity and the longevity of the disease can vary greatly, though. For some patients, a treatment of conservative therapy with bowel rest may be sufficient; others may require more aggressive antibiotics or even surgery. The exact cause of diverticulitis is unknown. It was previously thought that a high fiber diet may help alleviate the pressure in the colon, thereby lowering the chances of diverticulitis forming. However, in a study designed to test this theory exactly, it was shown that patients with a high fiber diet actually had an increased frequency of developing diverticulitis. Most cases of diverticulitis are diagnosed by use of a CT scan. CT scans are cited to be very accurate (98% effective) in diagnosing diverticulitis. Symptoms of diverticulitis may include one or more of the following: abdominal pain nausea vomiting fever cramping constipation While the Social Security Administration (SSA) does not have a listing that directly addresses diverticulitis in its Listing of Impairments, your diverticulitis may be disabling enough that you meet Social Security’s definition of disability in a different way. In order to receive Social Security disability benefits for diverticulitis, you must prove one of two things: the symptoms you experience are at least equal in severity to the symptoms of another condition in Social Security’s Listings, or the symptoms you experience prevent you from performing all of the demands of a full-time job on a regular and continuing basis. One possible way a claimant might qualify for Social Security disability benefits for diverticulitis is to equal the listing for inflammatory bowel disease (IBD). IBD is listed under Section 5.06 of the SSA’s Listing of Impairments, and it has many of the same symptoms as diverticulitis. To meet the listing for IBD you must show one of the following: two … Continued